• E-mail
• Print
• RSS

Topic: Take note of global period for podiatry procedures

Ambulatory Surgery Reimbursement Update, September 23, 2008

Physicians and ASC staff members, especially if they schedule patients, need to know the global period for procedures, says Michael Warshaw, DPM, CPC, FACFAOM, healthcare consultant and practicing podiatrist in Ravenna, OH.

Most, if not all, podiatry procedures performed at an ASC have a 90-day global period, which is the number of postoperative days that the carrier determines you should include in the procedure. “You have to be aware of this because it would directly affect the scheduling of any other procedures you would perform on that patient subsequent to that initial procedure date,” Warshaw says.

For example, Warshaw says, if the physician performs a hammertoe procedure on a patient, and the patient comes back in fewer than 90 days for another procedure, this will affect reimbursement and result in a lower payment for the ASC because the payer would assume this is a secondary procedure. It’s important to note that the 90-day period starts the day before a physician performs a procedure, as opposed to the actual day of the procedure.

In this case, as in others, the proper use of modifiers plays a vital role in reimbursement. If the physician performs a separate, unrelated procedure during that global period, aside from documenting in the medical record that this second procedure is unrelated to the primary procedure, Warshaw says, reporting modifier -79 shows the carrier that the procedures are not related.

When reporting modifier -79, remember that the medical record needs to demonstrate to the carrier that:

• The second procedure was unrelated to the first procedure
• The physician should not have performed the second procedure when he or she performed the initial procedure

Editor’s note: This topic is from the September 2008 issue of Ambulatory Surgery Coding and Reimbursement Insider.

• E-mail to a Colleague
• Print
• RSS
• Archive